Brugada pattern masquerading as ST-segment elevation myocardial infarction in flecainide toxicity
Lovely Chhabra1, David H Spodick
1Department of Internal Medicine, University of Massachusetts Medical School, Worcester, MA 01608, USA. lovids@hotmail.com
Abstract:
Flecainide (a class 1c antiarrhythmic) produces a dose-dependent decrease in intracardiac conduction. Its well known common electrocardiographic effects are prolongation of PR and QT intervals and the QRS complex duration. We report a case of flecainide toxicity in an elderly female who presented with a type 1 Brugada pattern who essentially had a previously normal ECG pattern on therapeutic dose of flecainide therapy. The case describes a rare electrocardiographic abnormality induced by flecainide toxicity which otherwise could be easily misinterpreted as a ST-segment elevation myocardial infarction (STEMI) without lack of expertise and high clinical suspicion.
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